Provider Demographics
NPI:1750910204
Name:NUEVA VIDA GARDENS ALF CORP.
Entity type:Organization
Organization Name:NUEVA VIDA GARDENS ALF CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-757-0065
Mailing Address - Street 1:18078 NW 41ST CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3425
Mailing Address - Country:US
Mailing Address - Phone:786-757-0065
Mailing Address - Fax:
Practice Address - Street 1:18078 NW 41ST CT
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-3425
Practice Address - Country:US
Practice Address - Phone:786-757-0065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility